با سلام خدمت کاربران در صورتی که با خطای سیستم پرداخت بانکی مواجه شدید از طریق کارت به کارت (6037997535328901 بانک ملی ناصر خنجری ) مقاله خود را دریافت کنید (تا مشکل رفع گردد).
ردیف | عنوان | نوع |
---|---|---|
1 |
Big Data to Assess Potential Pregnancy-Related Cardiovascular Complications of Difficult LabourdOriginal Investigator-Driven Research Is Not Dead!
داده های بزرگ برای ارزیابی عوارض قلبی عروقی مرتبط با بارداری ناشی از کار دشواری تحقیقات اصلی محققان از بین نرفته است-2018 Medical silos have rightly been castigated for providing inef
ficient care. However, the negative effect fragmentation of
health services has on medical research is rarely considered,
particularly when outcomes might occur several years down
stream. In this issue of the Canadian Journal of Cardiology,
Kahane and colleagues address this shortcoming by
reporting their study of dysfunctional uterine activity in la
bour and subsequent premature adverse cardiac events.1 This
population-based cohort study examined 1,608,720 Ontario
women from 1992 to 2016 with 1 singleton hospital live
birth at 24-41 weeks’ gestation. The primary exposure of
interest was a prolonged first stage of labour and the main
outcome was a composite of heart failure, cardiomyopathy, or
dysrhythmia occurring after the index delivery. A covariate
adjusted survival analysis with a median follow-up of > 10
years produced a hazard ratio of 1.09 (95% confidence in
terval, 0.87-1.36), leading to the authors’ conclusion that
women with prolonged labour do not appear to be at a higher
short-term risk for these cardiac outcomes. This report raises
several interesting questions. In the first place, why even study
this association? Next, are the conclusions reliable? Finally, do
the results matter?
|
مقاله انگلیسی |
2 |
Clinically relevant potential drug-drug interactions among outpatients: A nationwide database study
تعاملات بالقوه دارو-دارو در میان بیماران سرپایی بالینی: یک مطالعه پایگاه داده در سراسر کشور-2017 Background: Adverse drug events due to drug-drug interactions (DDIs) represent a considerable public
health burden, also in Slovenia. A better understanding of the most frequently occurring potential DDIs
may enable safer pharmacotherapy and minimize drug-related problems.
Objectives: The aim of this study was to evaluate the prevalence and predictors of potential DDIs among
outpatients in Slovenia.
Methods: An analysis of potential DDIs was performed using health claims data on prescription drugs
from a nationwide database. The Lexi-Interact Module was used as the reference source of interactions.
The influence of patient-specific predictors on the risk of potential clinically relevant DDIs was evaluated
using logistic regression model.
Results: The study population included 1,179,803 outpatients who received 15,811,979 prescriptions. The
total number of potential DDI cases identified was 3,974,994, of which 15.6% were potentially clinically
relevant. Altogether, 9.3% (N ¼ 191,213) of the total population in Slovenia is exposed to clinically
relevant potential DDIs, and the proportion is higher among women and the elderly. After adjustment for
cofactors, higher number of medications and older age are associated with higher odds of clinically
relevant potential DDIs. The burden of DDIs is highest with drug combinations that increase risk of
bleeding, enhance CNS depression or anticholinergic effects or cause cardiovascular complications.
Conclusion: The current study revealed that 1 in 10 individuals in the total Slovenian population is
exposed to clinically relevant potential DDIs yearly. Taking into account the literature based conservative
estimate that approximately 1% of potential DDIs result in negative health outcomes, roughly 1800 in
dividuals in Slovenia experience an adverse health outcome each year as a result of clinically relevant
potential interactions alone.
Keywords: Potential drug-drug interactions | Outpatients | Database research | Health claims data | Drug related problems |
مقاله انگلیسی |